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Approach to Treatment for Adhesive Capsulitis

A decision regarding whether and when to provide treatment for a medical condition is most often based on a complete understanding of the natural history of that disease. Unfortunately, the natural history of adhesive capsulitis is poorly understood. Although reports on this disease and its treatment have been numerous, clinical observations have varied widely with regards to the degree of disability and the duration of symptoms encountered. The response to treatment has also varied widely due to the employment of many different treatment regimens with confounding variables and conflicting results. Historically, idiopathic adhesive capsulitis has been referred to as a self-limited condition that usually resolves in 1 to 3 years regardless of treatment. Numerous studies, however, have described symptoms and disability that persist in 20% to 50% of patients for as long as 7 to 10 years. For this reason, the treatment approach of benign neglect often accepted in the past seems inappropriate, and intervention to reduce its impact upon the lives of its victims is clearly appropriate.

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